Open Enrollment Benefits August 1 _ 31, 2014 Wylie ISD
PPO Dental Plan Lincoln Benefit- High Option 100/80/50 Plan design option with $1000 maximum annual benefit Benefits for oral surgery, surgical extractions, and anesthesia will move from Type 2 coverage, covered at 80%, to type 3 coverage, covered at 50% Claims paid at 90 th percentile of usual & customary fees Coverage for dependent children up to age 26 Orthodontia included for children Premiums Employee Only$35.34 per month Employee & Spouse$76.44 per month Employee & Child$70.28 per month Employee & Family$ per month
PPO Dental Plan Lincoln Benefit- Low Option Provides a lower more basic level of coverage. 100/70/40 Plan design option with $750 maximum annual benefit Benefits for oral surgery, surgical extractions, and anesthesia will be covered as Type 3 coverage, covered at 50% Claims paid at 90 th percentile of usual & customary fees Coverage for dependent children up to age 26 No Orthodontia coverage Premium are guaranteed for 2 years Employee Only$25.18 per month Employee & Spouse$54.02 per month Employee & Child$48.50per month Employee & Family$85.22 per month
DHMO Dental Plan Lincoln Benefit- DHMO No co-pay on office visit; many other deeply discounted services No annual maximum benefits or deductibles Members must choose a provider from the network to receive benefits Employee Only$14.69 per month Employee & Spouse$28.62 per month Employee & Child$30.97 per month Employee & Family$44.76 per month
Cancer Plan Colonial Cancer Single plan option including Cancer coverage, ICU rider, Specified Disease Coverage, and 1 st Occurrence Benefit Hospital Confinement Benefit Radiation/Chemo Surgery Schedule Benefit Initial Diagnosis Screening Rebate $300 per day $300 per day with $10,000 per year Up to $4,500 max $5,000 $100 Open Enrollment, Guarantee issue coverage. Employee Only$29.85 per month Employee & Family$49.55 per month
Vision Plan Block Vision Exam and eyewear co-pay of $15 Elective Contact lens allowance of $150; Paid in full if medically necessary Frame allowance up to $125 retail value $200 allowance on Lasik Employee Only$7.40 per month Employee & Spouse$12.58 per month Employee & Child$13.30 per month Employee & Family$19.98 per month
Basic & Voluntary Group Term Life Plan Lincoln Benefit $15,000 Life Insurance Coverage for all Employees- Provided at no cost by Wylie ISD Additional voluntary coverage available at group rates. ex: $50,000 Coverage Age 25- $4.75 Age 35- $6.25 Age 45- $13.00 Age 55- $30.00 Age 65- $65.50 Spouse Coverage also available, Child Life up to age 26 Guaranteed Issue Coverage to $200,000 employee, $50,000 Spouse Annual increases of $20,000 up to the guaranteed issue limit on voluntary life each year at open enrollment. Coverage good while employed with Wylie ISD.
Disability Insurance Standard Insurance Open enrollment, guaranteed issue opportunity in 2014 Protects against a loss of income due to sickness or accident 1 st Day hospital confinement benefit- Waives elimination period on 0/7, 14/14, 30/30 elimination period plans. Insure up to 66.67% of annual salary- $8000 maximum monthly benefit. Elimination PeriodRate Per $1000 0/7$ /14$ /30$ /60$ /90$15.80
Permanent Life Plan Fidelity Life Permanent, Guaranteed Issue, Life Time Protection, Term Life Insurance Policy. Plus- Long Term Care Rider equal to 4% of death benefit, payable for 75 months. Ex: $25,000 death benefit or $1000 monthly LTC benefit payable for 75 Months. 75 month LTC benefit is new for 2013, current policies include a 25 month LTC benefit Portable upon termination of employment- Premium remains the same. Insure yourself, spouse, and children. Guaranteed issue for all employees up to $100,000. Rates Based on age at issue, guaranteed for life ex: $25,000 Non-Smoker Benefit, monthly premium: Age 35- $15.77 Age 45- $26.27 Age 55- $47.50
Medical Gap Plan Specialty Insurance Services Bridges the gap between Active Care 1HD and Active Care 2 benefits by: Paying $1,500 per year for each covered person for hospital confinement Paying $4,500 ($1,500 per occurrence) max per year for 3 occurrences of outpatient services – includes ER visit, MRI, x-ray, lab, outpatient surgery (excludes doctor office visit cost) Guaranteed issue No pre-existing condition if not subject to pre-existing condition on medical plan Also bridges the gap between Active Care 2 and Active Care 3 benefits Employee Only Employee Spouse >40 $25.98 $ $34.21 $ $71.85 $ Employee Children Employee Family $62.45 $83.64 $67.22 $95.11 $ $182.41
Flexible Spending Account TASC Medical Expense Reimbursement and Dependent Care Reimbursement Debt Card Smart Phone and Tablet Apps MyCash Account Medical Expense ReimbursementDependent Care Expense Reimbursement Dr. Visit Co-paysDay Care Expenses Deductible expensesElderly Care Expenses Rx Co-pays Uninsured Dental/Vision Expenses
DateTimeLocation August 4 th 11a.m. – 6p.m.ESC Building August 5 th – August 7 th 8a.m. – 5p.m.ESC Building August 8 th 11a.m. – 6p.m.ESC Building August 11 th – August 15 th 8a.m. – 5p.m.ESC Building Open Enrollment - Enrollers Onsite Third Party Administrator, US Employee Benefits